By Sola Ogundipe

An enlarged prostate is the most common prostate problem in men after the age of about 50. Having an enlarged prostate does not mean you have cancer. In some cases, an enlarged prostate can cause the urethra to narrow which can slow down or stop the flow of urine.  Many men over the age of 50 will have an enlarged prostate gland but not all will get symptoms.

The balance of hormones in your body changes as you get older and this may cause your prostate gland to grow. A Consultant General & Urological Surgeon, Dr. Leslie Akporiaye says there is a direct relationship between age and prostate enlargement. Akporiaye, who is the Chief Medical Director, Delta State University Teaching Hospital, Oghara, Delta State, however opined that there is no relationship between prostate enlargement and development of prostate cancer.

There is a pattern of occurrence within the prostate. As men get older, the prostate gets larger in size and weight, person to person. But there is no relationship between prostate enlargement and prostate cancer. Really, size has no bearing to causing development of cancer. The prostate can be small and stop you from passing urine. It can be enlarged and you’ll go about your life normally.

Enlargement of the prostate is essentially an expression of age.  It is in-born; it happens to every man. At 45, the prostate is not expected to be the same as at 25. One other thing that is an expression of age is development of prostate cancer. Prostate cancer kills 3 percent of men. But that is a large number if you look at 3 percent of a country like Nigeria.

If there is metastasis, then there is the possibility of danger and fatality.  Bone scan is now done now in Nigeria, but people do not know because it is not well publicized. In this part of the world, my advice is that you do not do general screening arbitrarily.
A person who should go for screening and who should do a test is someone who has experienced symptoms that took him to a doctor. Such person needs to do evaluation to know the extent to which the malady has advanced.

I’ve been doing screenings and biopsies in Nigeria since 1997. You can do it and come up with PSA of 100; if you repeat the biopsy, typically every six months, if all is well, the PSA should drop to 1 or below, if all is not well, a high PSA means the cancer has spread to the bones. It the PSA is above 20, the person is more than likely to have developed cancer. So why treat locally when it has gone far? The essence of drug treatment is to reduce or stop testosterone production.

As a man, you could be advised to have your testicles removed. About 25 years ago, that was the only option. It is irreversible. When the testicles are removed, they take your life from you. The idea is to minimize or eliminate testosterone. It is such an irreversible procedure. Commonest symptoms include series of waking up of night, the force of urine not normal, the bladder does not empty completely, there is dribbling at the end of urination, many incidences of enlargement and cancer in the same gland. There is really no new benefit to local treatment if the cancer has spread to surrounding organs. There is benefit from the drugs, even if you interrupt for six months benefit does not change.